May 2018 Volume LIII Number 3

Pediatric Oral Health Research and Policy Center Updates

November 2017 Volume LII Number 6

If You Are One of the 2,549—the AAPD Thanks You

A total of 2,549 AAPD members responded to the 2017 Survey of Pediatric Dental Practice, contributing valuable time during their busy summer schedules to provide worthwhile information on their patients and practices. The survey was distributed to 6,505 selected members during June and July. The response rate of 39 percent (2,549/6,505) was remarkable in view of the barrage of survey requests typically faced by AAPD members. Selected at random from all survey participants, Dr. Nicholas S. Katchen of Livingston, New Jersey, was the winner of two free registrations to the AAPD 2018 Annual Session in Honolulu, Hawaii.

Similar to the ADA/AAPD Survey of Dental Practice of 2011, this survey will supply current information on critical functions of pediatric dental practices, as well as offer insights into the com- prehensive pediatric dentist workforce study being conducted by the Center for Health Workforce Studies, Albany, N.Y. The high response rate of survey participants will help create more accurate predictive models of future supply and demand for pediatric dentists in the workforce study results.

This technical brief presents the findings of a POHRPC research project on state Medicaid cover- age of selected dental procedures by Erica Caffrey, D.D.S., M.S., 2016-2017 Samuel D. Harris Fellow. It identifies the pediatric dental procedures most es- sential for coverage, catalogs the coverage of these procedures by state, and specifies problem areas of coverage for oral health services. Designed as a state-level advocacy resource, this publication will be of valuable assistance to members as they champion for extended access to care through public insurance of oral health services for children. The brief was co-authored by Anupama R. Tate, D.D.S., M.S.; Scott W. Cashion, D.D.S., M.S.; Jessica Y. Lee, D.D.S., M.S.; Paul Casamassimo, D.D.S., M.S.; Robin Wright, M.A., Ph.D.; C. Scott Litch, M.A., J.D.; Mary Essling, R.D.H., M.S.

The AAPD Policy Center is pilot testing a predictive model for caries as a part of a three- year study of oral health in primary care. A sample of patient records from Nationwide Chil- dren Hospital’s baby dental clinic from between January and July of 2017 are being studied to test the predictive model developed earlier this year.

The predictive model is based on information readily available in the medial record and aims to characterize the likelihood that, based upon information noted in the early well-child visits, subjects would have predictable outcomes correlating with oral health disease. The out- comes were defined as patients having either dental caries at the time of their first dental visit or a high value on the caries risk assessment performed at their first dental visit.

A child’s age at the first dental visit was a strong predictor of caries risk in both outcome models. In other words, the timing of the first visit accounts for a good portion of the models’ abilities to predict the proportion of patients with existing caries or high risk for caries. Four risk factors were statistically significant and retained in the predictive model for high risk of caries:

• Age at the first dental visit
• Language other than English
• Breast feeding
• 20 percent no-show rate for health-related appointments

This study demonstrates that risk factors present in a child’s medical record may be used to predict the presence of dental disease and/or the assessment of high caries risk at the time of the child’s first dental visit. Predictive models may be used to refer children for dental care based only on information available in current medical records from well-child visits.

Visit the POHRPC webpage at http://www.aapd.org to view the full Year 2 Report.

AAPD Research Agenda Update

The Council on Scientific Affairs, chaired by Donald L. Chi, D.D.S., Ph.D., updated the AAPD Research Agenda for 2017 – 2018 to encourage evidence-based clinical care and help improve patient and population oral health. The Research Agenda, as ap- proved by the AAPD board of trustees, urges funding agencies to devote resources to the following areas:

• Prevention and management of dental caries (e.g., biosensors and technologies to monitor health, precision oral health care, emerging chemotherapeutics).
• Interdisciplinary research to understand and eliminate oral health disparities and promote population oral health (e.g., basic behavioral and social determinants of health, development of evidence- based public health interventions, inte- gration of dentistry into the health care delivery system, interoperable databases between medicine and dentistry, models of inter-professional collaboration, train- ing, and team science).
• Translational research to move scien- tific knowledge into practice and policy (e.g., dissemination and implementation of evidence-based care into clinical practice, barriers to dissemination and implementation, policy and practice partnerships).